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局部晚期头颈部鳞状细胞癌诱导化疗前后手术可切除性的比较评估

Comparative Evaluation of Surgical Operability with and without Induction Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma.

作者信息

Yelishetty Haraprathap, Yadav Jitendra Singh, Sethi Chandni, Chaurasia Rachna, Singh Mayank, Mahur Sachin, Tripathi Shalini, Bam Bomkar, Gupta Shraddha

机构信息

Maharani Laxmi Bai Medical College, Jhansi, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):626-632. doi: 10.1007/s12070-023-04230-1. Epub 2023 Oct 3.

Abstract

To compare and evaluation of surgical operability with and without induction chemotherapy in locally advanced head and neck squamous cell carcinoma. Head and neck malignancy grossly refers to squamous cell carcinomas of head and neck (HNSCC) have multiple treatment modalities and strategies, when opted in an appropriate manner renders tumours curable. The aim of this study is to compare and evaluation of surgical operability with and without induction chemotherapy in locally advanced head and neck squamous cell carcinoma. A prospective observational study involving 50 patients of histologically proven squamous cell carcinoma of head and neck region. Patients were categorized into two major groups, group-1 patients included resectable tumour stage and group-2 included unresectable tumour stage. Both groups were compared after appropriate chemotherapy and surgical intervention. There were a total of 78% males and 22% females with majority of patients in age group of 41-60 years. 54% patients had ulcerative type of growth pattern and most patients had primary site of lesion in oral cavity. 50% patients had moderately differentiated squamous cell carcinoma. Induction chemotherapy was considered in 70% of patients, while majority of patients were belonging to T4N2M0 stage. In this study, we recommend that the borderline category of patients who are initially in an unresectable tumour stage can undergo induction chemotherapy to downstage and shrink the tumour to a resectable stage following which the appropriate surgical intervention should be done with a close monitoring and sustained follow up to prevent recurrence.

摘要

比较和评估诱导化疗前后局部晚期头颈部鳞状细胞癌的手术可操作性。头颈部恶性肿瘤大体上指头颈部鳞状细胞癌(HNSCC),有多种治疗方式和策略,若选择得当可使肿瘤治愈。本研究的目的是比较和评估诱导化疗前后局部晚期头颈部鳞状细胞癌的手术可操作性。一项前瞻性观察性研究,纳入50例经组织学证实的头颈部鳞状细胞癌患者。患者分为两大组,第1组患者包括可切除肿瘤分期,第2组包括不可切除肿瘤分期。两组在进行适当的化疗和手术干预后进行比较。共有78%为男性,22%为女性,大多数患者年龄在41 - 60岁。54%的患者有溃疡性生长模式,大多数患者病变原发部位在口腔。50%的患者为中分化鳞状细胞癌。70%的患者接受了诱导化疗,而大多数患者属于T4N2M0期。在本研究中,我们建议最初处于不可切除肿瘤分期的临界患者可接受诱导化疗以使肿瘤降期并缩小至可切除阶段,之后应进行适当的手术干预,并密切监测和持续随访以预防复发。

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